The instability associated with anterior cruciate ligament rupture has created numerous problems and various possible solutions have been well documented in the literature.
U.S. Pat. No. 3,953,896, dated May 4, 1976, dislcoses a prosthetic ligament to be used to replace a damaged cruciate ligament. In this patent, the prosthetic ligament includes a cylindrical central portion of polyethylene and threaded outer portions provided with bushings to protect the central portion from abrasion caused by skeletal flexing. Fasteners, in the form of nut members, are also provided to fasten the prosthesis within the skeletal apertures.
U.S. Pat. No. 3,545,008, dated May 27, 1968, also discloses a tendon prosthesis which consists of a Dacron mesh sleeve sutured to the proximal ends of a ruptured tendon. The sleeve includes a mesh netting at its outer ends to encourage fibroblastic infiltration to occur between the severed ends of the tendon for anchoring the prosthesis to the tendon.
U.S. Pat. No. 4,187,558, dated Feb. 12, 1980, relates to a prosthetic ligament positioned within a surgically prepared passageway in the bone, and a Dacron and/or Dacron and silicone strand is disclosed as a replacement for a cruciate ligament with Dacron velour fabric used as collars at the outer ends of the central portion to promote new tissue growth.
U.S. Pat. No. 3,797,047, dated Mar. 19, 1974, discloses an artificial tendon material which consists of a tubular sheath of silicone elastomer with an inner tensile element of knitted fabric.
U.S. Pat. No. 3,805,300, dated Apr. 23, 1974, teaches a tendon which is composed of a cord-like combination of silicone and Dacron strip with transverse openings for the natural tendon to be woven therethrough.
In these prior art procedures, the damaged natural tendon is relaced with a synthetic member which is a biocompatible material, usually Dacron and/or silicone. One problem with these techniques is that the tendon prosthesis is essentially synthetic, except that some means is utilized to encourage functional anastomosis. For example: in the Bader U.S. Pat. No. 3,545,008, mesh flaps are sutured to the ends of the ruptured tendon and in the Alonso U.S. Pat. No. 3,805,300, the resected tendon is inter-woven through perforations in the synthetic cord member.
The present invention involves the replacement of a cruciate ligament with a composite synthetic and biological structure to provide maximum mechanical and structural stability, both short and long-term, after surgical reconstruction.
The principal object of this invention is to provide an improved method of surgically reconstructing a severely damaged or ruptured tendon.
Another object of this invention is to provide for ligament augmentation particularly adapted to the anterior cruciate ligament.